Collaboration is key: Patient engagement for healthcare improvement

The Bottom Line

  • The process of engaging patients in the design, management, delivery, and/or evaluation of public services is referred to as co-production.
  • Co-producing hospital services and tools may lead to higher satisfaction, usability, uptake, and retention in health care providers; while reducing wait times, enhancing the delivery of home medication and understanding of medications used, and improving knowledge, confidence, and skills in patients.
  • Those interested in being involved in the co-production process should seek out available opportunities. Patient advocacy groups, your health care team, and hospital websites may be good sources to help identify or refer you to such opportunities.   

Have you ever heard the sayings “Teamwork makes the dream work” and “'We are stronger together than we are alone'”?  Well, they just so happen to be true! From playing team sports to class projects to moving heavy furniture, we all experience moments in our lives that require us to work hand in hand to complete a task or achieve a common goal. What’s more, these days, our input is highly sought after. Think back to when you were last emailed a customer satisfaction survey following a visit to a store or asked to rate an app on your tablet or smartphone. Our feedback is valuable because it allows the companies and organizations providing us with products and/or services to better understand their userbase and optimize their offerings.

Luckily, the benefits of collective action and providing opportunities for users to share their thoughts, opinions, and experiences are wide-reaching—even extending to the health space. For instance, collaboration or dialogue between patients, caregivers, and health care providers through hospital-discharge planning, personalized care planning, and advanced care planning can reduce hospital readmissions, improve aspects of physical and mental health, and increase the chances of the patient’s wishes being followed, respectively (1-3). The question then becomes, can engaging patients in decision making that goes beyond interventions related to their individual care and involves the design, management, delivery, and/or evaluation of public services also yield positive outcomes? This type of activity is known as co-production and can be voluntary or involuntary (4;5). A rapid review evaluating the co-production of hospital tools and resources with patients adds more to this conversation (4).

What the research tells us

Within the review, co-produced services and tools included ‘teachback’ (a technique that aims to increase patients’ understanding of instructions provided by a health care provider), patient incident reporting tools, patient-oriented discharge summaries, lists of questions to encourage discussion between patients, caregivers, and care providers, and an information and communication technology platform for patient-reported symptoms. The intensity at which patients were engaged in the co-production process varied. For example, some patients were ‘consulted’ through interviews or surveys, others were ‘involved’ through workshops and focus groups, and a few were ‘partners’ participating in meetings, experience-based collaboratives, and working groups.

To summarize, the review found that co-production may help to improve organizational/health care provider outcomes and patient level outcomes. In terms of organizational/health care provider outcomes, co-produced services and tools may rate high to moderate when it comes to user satisfaction, usability, uptake, and retention. In terms of patient outcomes, co-produced services and tools have the potential to reduce wait times, as well as enhance the timely delivery of home medication and patients’ understanding of their medication. They may also improve knowledge, confidence, and skills in patients involved in the co-production process.

Despite some of these promising results, it’s important to note that more research on the effects of co-production on patients and health care providers is needed to make definitive conclusions on the use of this strategy. A greater understanding of the impact on patients’ health outcomes would be especially useful (4). In the meantime, those interested in voicing their opinions and sharing their experiences to help inform health care-related tools and resources can seek out available opportunities to do so. Patient advocacy groups, your health care team, and trusted hospital websites are a few sources that may help link you to these opportunities and are a good starting point for your search.

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Author Details


  1. Rodakowski J, Rocco PB, Ortiz M, et al. Caregiver integration during discharge planning for older adults to reduce resource use: A metaanalysis. J Am Geriatr Soc. 2017; 65(8):1748-1755. doi: 10.1111/jgs.14873.
  2. Coulter A, Entwistle VA, Eccles A, et al. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database Syst Rev. 2015; 3:CD010523. doi: 10.1002/14651858.CD010523.pub2.
  3. Weather E, O’Caoimh R, Cornally N, et al. Advance care planning: A systematic review of randomized controlled trials conducted with older adults. Maturitas. 2016; 91:101-109. doi: 10.1016/j.maturitas.2016.06.016.
  4. Lim S, Morris H, Pizzirani B, et al. Evaluating hospital tools and services that were co-produced with patients: A rapid review. Int J Qual Health Care. 2020; 32(4):231-239. doi: 10.1093/intqhc/mzaa020.
  5. Osborne SP, Radnor Z, Strokosch K. Co-production and the co-creation of value in public services a suitable case for treatment? Public Manag Rev. 2016; 18:639-653. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

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